Dr. Fanasy Prokop Jefcoat
Periodontist
101 Webster Circle Suite 100
Madison
, Mississippi 39110
Dr. Fanasy Prokop Jefcoat
Periodontist
101 Webster Circle Suite 100
Madison
, Mississippi 39110
(601) 605-6508
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Dr. Fanasy Prokop Jefcoat
- 2044 Tidewater Ln
- Madison, MS
- Zip : 39110-8927
- Fax : (601) 605-6508
- Phone : (601) 605-6511
Second Address
- Dr. Fanasy Prokop Jefcoat
- 101 Webster Circle Suite 100
- Madison, MS
- Zip : 39110
- Fax : (601) 605-6508
- Phone : (601) 605-6511
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0300X | Periodontist | 3251-03 | MS |
National Provider Identifier
| NPI | 1154401909 |
|---|---|
| Provider Name | Dr. Fanasy Prokop Jefcoat |
| First Address | Madison, MS 39110-8927 |
| Second Address | Madison, MS 39110 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/10/2006 |
| Last Update Date | 07/02/2017 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.